Bloody Stool in Infants: A Pediatric Allergy View

Year 2023, Volume: 17 Issue: 4, 304 - 308, 25.07.2023

Gizem Atakul , Seda Şirin , Özge Atay , Özge Kangallı Boyacıoğlu , Serdar Al , Suna Asilsoy , Nevin Uzuner , Özkan Karaman

https://doi.org/10.12956/tchd.1198501

Abstract

Objective: The prevalence of food allergy (FA) has gradually increased. Bloody stool is among the symptoms associated with non-immunoglobulin E (IgE) mediated FA in infants. In our study, we shared the clinical characteristics of the patients who applied to our clinic with bloody stool.

Material and Methods: The data of the patients with bloody stool were reviewed. Patients’ characteristics and the time of onset of tolerance in patients with FA were recorded, retrospectively.

Results: The 110 patient files were reviewed. 68% of the patients were diagnosed with FA (63 proctocolitis/12 enterocolitis), 22% with an anal fissure, and 9% with nonspecific colitis. The most common causative food was cow milk (57%), the second was the combination of egg and milk (24.2%), and the third was egg (18.2%). The presence of atopic dermatitis (AD) and eosinophil count at the time of admission did not affect tolerance development time but it was shown that skin prick test (SPT) positivity and the high level of total IgE at the time of admission delayed the development of tolerance [(p=0.02), (r=0.510, p=0.009)].

Conclusion: Bloody stool is one of the common complaints in infants. It does not always indicate a FA. The clinic is mild when the underlying disease is non-IgE mediated FA. However, accompanying IgE-type sensitivities negatively affect the prognosis. Elevated total IgE and SPT positivity at the time of diagnosis may give an impression that tolerance of baked products could be delayed in this type of allergy.

Keywords

Atopic dermatitis, Food allergy, Gastrointestinal hemorrhage, Infant, Proctocilitis

İnfantlarda Kanlı Gayta: Pediatrik Alerji Bakışı

Abstract

Amaç: Besin alerjisi (BA) sıklığı giderek artan bir hastalıktır. Kanlı gayta yakınması infantlarda non immunoglobulin E (IgE) aracılı BA ile ilişkilendirilen semptomlar arasındadır. Çalışmamızda kanlı gaita nedeniyle kliniğimize başvuran hastaların klinik özellikleri paylaşılmıştır.

Gereç ve Yöntemler: Kanlı gaitası olan hastaların verileri incelendi. Hastaların özellikleri ve BA saptanan hastalarda toleransın ne zaman geliştiği restrospektif kaydedildi.

Bulgular: 110 hastanın kayıtları incelendi. Bunlardan %68’i BA (63 proktokolit/12 enterokolit), %22’si anal fissür, %9’u nonspesifik kolit tanısı aldı. Şüpheli besin olarak en sık inek sütü (%57), ikinci sıklıkta yumurta ve süt birlikteliği (%24.2), üçüncü sıklıkta yumurta (%18.2) saptandı. Atopik dermatit (AD) olması, başvuru anındaki eozinofil sayısı tolerans zamanını etkilemezken deri prick test (DPT) pozitifliği ve başvuru anındaki yüksek total IgE düzeyinin toleransı geciktirdiği bulundu [(p=0.020), (r=0.510, p=0.009)].

Sonuç: Kanlı gaita, infantil dönemde sık karşılaşılan şikayetlerden biridir. Her zaman besin alerjisine işaret etmez. Altta yatan hastalık non-IgE kaynaklı BA olduğunda klinik ılımlıdır .Ancak eşlik eden IgE tipi duyarlılıklar prognozu olumsuz etkiler. Tanı anındaki total IgE yüksekliği ve DPT pozitifliği bu tip alerjilerde fırınlanmış ürün toleransının geç olacağı yönünde fikir verebilir.

Keywords

Atopik dermatit, Besin alerjisi, Gastrointestinal hemoraji, İnfant, Proktokolit

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